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五种检查仪器对角膜水平直径测量的对比分析 被引量:5
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作者 张小兰 龚芮 +1 位作者 王顺清 黄永志 《国际眼科杂志》 CAS 北大核心 2019年第4期704-708,共5页
目的:分析五种角膜直径测量方法对角膜水平直径测量的相关性和一致性。方法:纳入2018-02/03在四川大学华西医院眼科行双眼ICL植入的患者25例50眼,术前分别采用规尺、眼前节分析系统SIRIUS、IOL Master500、眼前节OCT和UBM 5种方法测量... 目的:分析五种角膜直径测量方法对角膜水平直径测量的相关性和一致性。方法:纳入2018-02/03在四川大学华西医院眼科行双眼ICL植入的患者25例50眼,术前分别采用规尺、眼前节分析系统SIRIUS、IOL Master500、眼前节OCT和UBM 5种方法测量角膜水平直径,比较5种方法测量结果的相关性及一致性。结果:规尺、眼前节分析系统SIRIUS、IOL Master500、眼前节OCT和UBM测量的角膜水平直径分别为11.54±0.30、11.77±0.33、11.98±0.33、11.63±0.35、11.53±0.34mm(P<0.05),q检验结果显示规尺法与UBM法、眼前节OCT法,UBM法与眼前节OCT法测量的WTW值之间均无差异(P>0.05),直线相关分析发现五种检查方法测量值之间均具有显著相关性,Bland-Altman分析发现,规尺与SIRIUS、UBM、眼前节OCT检查值的95%LoA上下限绝对值均≤0.50mm。结论:五种测量角膜水平直径的结果,规尺与SIRIUS,UBM和前节OCT的结果可以互换,其他结果不能互换。IOL Master500测量值最大,不宜作为测量角膜水平直径大小的诊断依据,其他测量设备检查结果应结合临床实践。 展开更多
关键词 角膜水平直径 规尺 SIRIUS眼前节分析系统 IOL Master500 眼前节OCT 超声生物显微镜 一致性分析
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CASIA SS-1000 OCT与Sirius眼前节分析系统测量角膜厚度的比较 被引量:5
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作者 孙成淑 张小兰 黄永志 《国际眼科杂志》 CAS 北大核心 2018年第1期153-155,共3页
目的:比较扫频CASIA SS-1000 OCT与Sirius眼前节分析仪两种仪器测量正常人角膜顶点厚度(CCT)和最薄点角膜厚度(TCT)结果的差异性、相关性及一致性,为临床的应用提供理论依据。方法:前瞻性研究。收集近视患者34例,均由同一熟练操作者对... 目的:比较扫频CASIA SS-1000 OCT与Sirius眼前节分析仪两种仪器测量正常人角膜顶点厚度(CCT)和最薄点角膜厚度(TCT)结果的差异性、相关性及一致性,为临床的应用提供理论依据。方法:前瞻性研究。收集近视患者34例,均由同一熟练操作者对受检者右眼进行测量,先采用Sirius眼前节分析仪,再使用SS-1000 OCT重复测量角膜厚度。配对t检验及Bland-Altman用于评估SS-1000 OCT与Sirius眼前节分析仪的角膜顶点及角膜最薄点的一致性。结果:SS-1000 OCT及Sirius角膜地形图仪测量CCT的角膜顶点均值分别为517.62±25.29、518.47±27.23μm。SS-1000 OCT及Sirius眼前节分析仪CCT的角膜最薄点均值分别为513.53±25.06、515.32±26.69μm。两者角膜顶点角膜厚度比较,差异无统计学意义(P>0.05),但两者角膜最薄点的角膜厚度比较,差异具有统计学意义(P<0.05)。两种设备测量的角膜厚度有较好的相关性(r=0.969、0.965,均P<0.05)。做Bland-Altman分析,角膜顶点厚度的95%一致性界限为(-14.22μm,12.52μm),角膜最薄点厚度的95%一致性界限为(-15.61μm,12.03μm),4%(3/68)的点在95%一致性的界限外,但角膜最薄点的一致性差异更大。结论:SS-1000 OCT测量CCT与Sirius眼前节分析仪具有高度的一致性,在临床工作中,可以考虑相互替代。 展开更多
关键词 眼前节OCT 眼前节分析仪 顶点角膜厚度 最薄点角膜厚度 一致性分析
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有晶状体眼后房型人工晶状体植入术后患者干眼情况 被引量:3
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作者 缪娜 邓应平 +5 位作者 张小兰 王顺清 孙成淑 邱乐梅 龚芮 马可 《国际眼科杂志》 CAS 北大核心 2021年第8期1457-1460,共4页
目的:研究有晶状体眼后房型人工晶状体(ICL)植入术后患者干眼相关的临床变化,评价其眼表疾病的严重程度。方法:前瞻性研究。纳入2019-09/10拟行ICL植入手术矫正近视的患者50例50眼。分别于术前,术后1wk,1、3mo时进行眼表疾病指数(OSDI)... 目的:研究有晶状体眼后房型人工晶状体(ICL)植入术后患者干眼相关的临床变化,评价其眼表疾病的严重程度。方法:前瞻性研究。纳入2019-09/10拟行ICL植入手术矫正近视的患者50例50眼。分别于术前,术后1wk,1、3mo时进行眼表疾病指数(OSDI)问卷评分和角膜染色评分(Oxford法)、泪膜破裂时间(TBUT)、基础泪液分泌量(SⅠt)、下睑中央泪河高度检查。结果:OSDI问卷评分在术后1wk,1mo时较术前明显增加(P<0.05),至术后3mo恢复至术前水平,角膜染色评分在术后3mo基本恢复至术前水平,术后3mo与术后1wk比较有差异(χ^(2)=5.267,P=0.022)。角膜染色评分在各个时间点均和OSDI问卷评分呈显著的正相关(rs>0,P<0.05)。TBUT在术后1wk及1mo较术前明显降低(P<0.05),术后3mo恢复至术前水平。SⅠt和下睑中央泪河高度在术后各个时间点与术前相比无差异(P>0.05)。结论:ICL植入术后早期会影响患者眼表泪膜的稳定性,使患者出现不同程度的干眼相关症状,OSDI问卷评分可以评价其主观不适症状。但到术后3mo,患者眼表泪膜稳定性恢复至术前水平。角膜染色阳性评分越高的患者,干眼相关症状越明显。 展开更多
关键词 有晶状体眼后房型人工晶状体植入术 干眼 眼表疾病指数问卷评分
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2种调强放疗技术联合紫杉醇脂质体同步治疗ⅡB-ⅢB期宫颈癌的临床疗效比较 被引量:9
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作者 金艳霞 张晓兰 宋静 《中国现代医学杂志》 CAS 北大核心 2017年第28期115-118,共4页
目的探讨适形调强放疗(IMRT)和容积旋转调强放疗(VMAT)2种调强放疗技术联合紫杉醇脂质体同步治疗ⅡB-ⅢB期宫颈癌的临床疗效和安全性差异。方法选取青海大学附属医院2014年5月-2016年5月收治ⅡB-ⅢB期宫颈癌患者80例。以随机数字表法分... 目的探讨适形调强放疗(IMRT)和容积旋转调强放疗(VMAT)2种调强放疗技术联合紫杉醇脂质体同步治疗ⅡB-ⅢB期宫颈癌的临床疗效和安全性差异。方法选取青海大学附属医院2014年5月-2016年5月收治ⅡB-ⅢB期宫颈癌患者80例。以随机数字表法分为A组和B组,每组40例,分别在紫杉醇脂质体化疗基础上同步采用IMRT和VMAT辅助治疗;比较两组患者近期疗效、中位总生存时间(OS)、中位无进展生存时间(PFS)、中位远处转移时间(DMR)、中位局部复发时间(LRR)、治疗前后卡氏评分(KPS)及药物毒副作用发生率等。结果两组患者近期疗效比较,差异无统计学意义(P>0.05);两组患者中位OS、PFS、DMR及LRR时间比较,差异无统计学意义(P>0.05);A、B组患者治疗后KPS评分与治疗前比较,差异有统计学意义(P<0.05),B组患者治疗后KPS评分高于A组;两组患者放射性直肠炎、放射性膀胱炎、消化道反应及肝功能损伤发生率比较,差异无统计学意义(P>0.05);B组患者骨髓抑制发生率与A组比较,差异有统计学意义(P<0.05),B组低于A组。结论 IMRT和VMAT分别联合紫杉醇脂质体同步治疗ⅡB-ⅢB期宫颈癌在控制疾病进展、延长生存时间及降低转移复发风险方面效果接近;但VMAT方案可有效降低骨髓抑制发生风险,提高日常生活质量。 展开更多
关键词 适形调强放疗 容积旋转调强放疗 紫杉醇脂质体 宫颈癌 疗效 安全性
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两种眼前节分析系统测量屈光手术前后波前像差的一致性 被引量:1
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作者 张小兰 王顺清 +1 位作者 孙成淑 马可 《国际眼科杂志》 CAS 北大核心 2018年第11期2016-2018,共3页
目的:研究SCHWIND和SIRIUS眼前节分析系统测量屈光手术患者手术前后像差结果的一致性。方法:前瞻性对照研究。选取2017-06/12于四川大学华西医院眼科行飞秒制瓣准分子激光原位角膜磨镶术的屈光不正患者180例360眼,采用SCHWIND和SIRIUS... 目的:研究SCHWIND和SIRIUS眼前节分析系统测量屈光手术患者手术前后像差结果的一致性。方法:前瞻性对照研究。选取2017-06/12于四川大学华西医院眼科行飞秒制瓣准分子激光原位角膜磨镶术的屈光不正患者180例360眼,采用SCHWIND和SIRIUS眼前节分析系统测量角膜平轴和陡轴曲率的度数和轴向、Kappa角度数及高阶像差等数据。结果:采用SCHWIND和SIRIUS眼前节分析系统测得的本组患者术前和术后1mo的角膜平轴度数和方向、陡轴度数和方向、术后1mo的Kappa角度数和方向、术前和术后1mo的彗差和三叶草数据差异均无统计学意义(P>0. 05)。术前,两种检测方法检测的总高阶像差和球差数据差异均有统计学意义(P<0. 01),SCHWIND测量值高于SIRIUS测量值;术后1mo,两种检测方法检测的总高阶像差和球差数据差异均无统计学意义(P>0. 05)。结论:SCHWIND和SIRIUS眼前节分析系统测量屈光手术患者手术前后影响成像质量的相关数据具有较好的一致性。 展开更多
关键词 眼前节分析系统 波前像差 飞秒激光
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In vivo hepatic differentiation potential of human umbilical cord-derived mesenchymal stem cells: Therapeutic effect on liver fibrosis/cirrhosis 被引量:19
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作者 Guo-Zun zhang Hui-Cong Sun +2 位作者 Li-Bo Zheng Jin-Bo Guo xiao-lan zhang 《World Journal of Gastroenterology》 SCIE CAS 2017年第46期8152-8168,共17页
AIM To investigate the hepatic differentiation potential of human umbilical cord-derived mesenchymal stem cells(h UC-MSCs) and to evaluate their therapeutic effect on liver fibrosis/cirrhosis.METHODS A CCl4-induced li... AIM To investigate the hepatic differentiation potential of human umbilical cord-derived mesenchymal stem cells(h UC-MSCs) and to evaluate their therapeutic effect on liver fibrosis/cirrhosis.METHODS A CCl4-induced liver fibrotic/cirrhotic rat model was used to assess the effect of h UC-MSCs. Histopathology was assessed by hematoxylin and eosin(H&E), Masson trichrome and Sirius red staining. The liver biochemical profile was measured using a Beckman Coulter analyzer. Expression analysis was performed using immunofluorescent staining, immunohistochemistry, Western blot, and real-time PCR.RESULTS We demonstrated that the infused h UC-MSCs could differentiate into hepatocytes in vivo. Functionally, the transplantation of h UC-MSCs to CCl4-treated rats improved liver transaminases and synthetic function, reduced liver histopathology and reversed hepatobiliary fibrosis. The reversal of hepatobiliary fibrosis was likely due to the reduced activation state of hepatic stellate cells, decreased collagen deposition, and enhanced extracellular matrix remodeling via the up-regulation of MMP-13 and down-regulation of TIMP-1. CONCLUSION Transplanted h UC-MSCs could differentiate into functional hepatocytes that improved both the biochemical and histopathologic changes in a CCl4-induced rat liver fibrosis model. h UC-MSCs may offer therapeutic opportunities for treating hepatobiliary diseases, including cirrhosis. 展开更多
关键词 Liver fibrosis/cirrhosis Mesenchymal stem cells Collagen metabolism HEPATOCYTE DIFFERENTIATION
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Effects and mechanism of adenovirus-mediated phosphatase and tension homologue deleted on chromosome ten gene on collagen deposition in rat liver fibrosis 被引量:4
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作者 Shu-rui Xie Jun-yan An +4 位作者 Li-bo Zheng Xiao-Xia Huo Jian Guo David Shih xiao-lan zhang 《World Journal of Gastroenterology》 SCIE CAS 2017年第32期5904-5912,共9页
AIM To evaluate the effects of phosphatase and tension homologue deleted on chromosome ten(PTEN) gene on collagen metabolism in hepatic fibrosis and the underlying mechanisms.METHODS rat primary hepatic stellate cells... AIM To evaluate the effects of phosphatase and tension homologue deleted on chromosome ten(PTEN) gene on collagen metabolism in hepatic fibrosis and the underlying mechanisms.METHODS rat primary hepatic stellate cells(HSCs) and human LX-2 cells were transfected with adenovirus containing c DNA constructs encoding wild-type PTEN(Ad-PTEN), PTEN mutant G129 E gene(Ad-G129E), and r NA interference constructs targeting the PTEN sequence PTEN short hairpin r NA to up-regulate and downregulate the expression of PTEN. HSCs were assayed using fluorescent microscopy, real-time polymerase chain reaction, and western blotting. Moreover, a CCl_4-induced rat hepatic fibrosis model was established to investigate the in vivo effects. Hematoxylin and eosin, and Masson's trichrome were used to assess the histological changes. The expression of collagen Ⅰ and Ⅲ was assessed using immunohistochemistry and western blot analysis.RESULTS Elevated expression of PTEN gene reduced serum levels of alanine transaminase and aspartate transaminase, decreased collagen deposition in the liver, and reduced hepatocyte necrosis. In contrast, knockdown of PTEN expression had an opposite effect, such as increased collagen deposition in the liver, and was molecularly characterized by the increased expression of matrix metalloproteinase(MMP)-13(P < 0.01) and MMP-2(P < 0.01), as well as decreased expression of the tissue inhibitor of metalloproteinase(TIMP)-1(P < 0.01) and TIMP-2(P < 0.01).CONCLUSION These data indicated that gene therapy using recombinant adenovirus encoding PTEN might be a novel way of treating hepatic fibrosis. 展开更多
关键词 Collagen metabolism Hepatic stellate cells Phosphatase and tension homologue deleted on chromosome ten PTEN Gene therapy Hepatic fibrosis
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内镜黏膜下剥离术治疗老年结直肠大面积侧向发育型肿瘤的临床研究 被引量:5
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作者 郑林福 邱建庭 +7 位作者 郑锦 李达周 陈龙平 张晓兰 江传燊 许斌斌 詹红丽 王雯 《中国内镜杂志》 2020年第12期18-23,共6页
目的回顾性分析老年直径≥30 mm结直肠侧向发育型肿瘤(LST)的内镜下表现,并探讨内镜黏膜下剥离术(ESD)的治疗效果及随访情况。方法回顾性分析2016年1月-2019年12月94例在该院行ESD治疗的直径≥30 mm结直肠LST患者的临床资料,其中老年组(... 目的回顾性分析老年直径≥30 mm结直肠侧向发育型肿瘤(LST)的内镜下表现,并探讨内镜黏膜下剥离术(ESD)的治疗效果及随访情况。方法回顾性分析2016年1月-2019年12月94例在该院行ESD治疗的直径≥30 mm结直肠LST患者的临床资料,其中老年组(≥60岁)49例,中青年组(30~59岁)45例。记录LST形态、部位、大小、ESD术后并发症、标本切除完整性、术后切缘情况和随访结果。结果两组患者均顺利完成ESD整块切除手术。老年组结直肠LST的平均大小为(43.10±18.49)mm,中青年组LST的平均大小为(43.27±21.43)mm,两组病灶均以直肠多见,镜下类型以结节混合型(LST-G-NM)多发,两组病灶平均大小、LST分布及形态学比较,差异均无统计学意义(P>0.05)。老年组7例术中穿孔(14.3%),3例术后并发出血(6.1%),中青年组1例术中穿孔(2.2%),2例术后并发出血(4.4%),两组并发症发生率比较,差异无统计学意义(P>0.05)。两组术后病理均以低级别上皮内瘤变(LGIN)多见,老年组中1例切缘阳性(2.0%),中青年组5例切缘阳性(11.1%),两组术后病理及切缘情况比较,差异均无统计学意义(P>0.05)。94例患者中86例完成术后随访,中位随访时间为21个月,无病灶残留或复发。结论老年结直肠大面积LST的内镜下表现与中青年患者相似,ESD治疗老年结直肠大面积LST安全、有效,且中远期效果与中青年患者相当。 展开更多
关键词 内镜下黏膜剥离术 老年 大面积 结直肠侧向发育型肿瘤
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Screening of prognostic genes associated with ferroptosis in esophageal adenocarcinoma and the establishment of its prognostic model 被引量:1
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作者 Fa-zhang Chen Jun-Song Wu +3 位作者 Ye Li Xue-Lian zhang xiao-lan zhang Ru-Yi Yang 《Medical Data Mining》 2022年第2期1-15,共15页
We analyzed three gene microarray datasets by GEO2R and obtained differential genes associated with ferroptosis in esophageal adenocarcinoma by obtaining the FerrDb database to obtain ferroptosis-related genes for the... We analyzed three gene microarray datasets by GEO2R and obtained differential genes associated with ferroptosis in esophageal adenocarcinoma by obtaining the FerrDb database to obtain ferroptosis-related genes for the intersection.To further elaborate on the functions of differentially expressed genes(DGEs),this study performed gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis on DEGs.We used the Kaplan-Meier plotter database to verify the effect of DGEs genes on the overall survival of esophageal adenocarcinoma.We performed univariate/multifactorial COX regression analysis of DGEs genes associated with esophageal adenocarcinoma prognosis by R language to obtain ferroptosis-associated independent prognostic genes.To further understand the relationship between the upstream molecules of independent prognostic genes and ferroptosis,we obtained the upstream regulatory molecules miRNAs and LncRNAs of prognosis-related ferroptosis genes with the help of the miRWalk database,Oncomi database and StarBase database.we obtained a total of 75 DEGs.These DGEs were mainly enriched in the cellular response to lipids,and negative regulation of intracellular.These DGEs were mainly enriched in the negative regulation of intracellular signaling,positive regulation of cell death,cellular autophagy,HIF-1 signaling pathway,microRNAs in cancer,and ferroptosis.We performed prognostic analysis and univariate/multifactorial COX regression analysis on 75 ferroptosis-related genes and established four independent genes for esophageal adenocarcinoma,ATF3,ATM,ATG5,and HMGB1.The study also established hsa-miR-876-5p,hsa-miR-186-5p,hsa-miR-421,hsa-miR-505-3p,hsa-miR-503-5p,hsa-miR-299-3p and hsa-miR-191-5p,seven miRNAs with upstream regulation of LncRNAs.these miRNAs can be competitively bound by LncRNAs to prevent the inhibition of translation of target gene expression by miRNAs.In conclusion,our study identified four esophageal adenocarcinoma independent prognostic genes and their upstream regulatory molecules.These genes are involved in the ferroptosis regulation of cells and also play an important role in tumor therapy and drug resistance as one of the disease therapeutic targets.The study suggests that by targeting ATF3,ATM,ATG5,HMGB1 and their upstream regulatory molecules is a new direction for the treatment of esophageal adenocarcinoma. 展开更多
关键词 Esophageal adenocarcinoma BIOINFORMATICS ferroptosis non-coding RNA
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Long noncoding RNA TNFRSF10A-AS1 promotes colorectal cancer through upregulation of HuR
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作者 Dan-Dan Wang Dong-Lei Sun +5 位作者 Shao-Peng Yang Jia Song Meng-Yao Wu Wei-Wei Niu Mei Song xiao-lan zhang 《World Journal of Gastroenterology》 SCIE CAS 2022年第20期2184-2200,共17页
BACKGROUND Recent studies have emphasized the emerging importance of long noncoding RNAs(lncRNAs)in colorectal cancer(CRC).However,the functions and regulatory mechanisms of numerous lncRNAs in CRC have not been fully... BACKGROUND Recent studies have emphasized the emerging importance of long noncoding RNAs(lncRNAs)in colorectal cancer(CRC).However,the functions and regulatory mechanisms of numerous lncRNAs in CRC have not been fully elucidated.AIM To explore the functional role and underlying molecular mechanisms of lncRNA TNFRSF10A-AS1 in CRC.METHODS TNFRSF10A-AS1 expression was measured by quantitative real-time polymerase chain reaction in CRC,and the relationship between TNFRSF10A-AS1 levels and the clinicopathological features of CRC patients was analyzed.The effect of TNFRSF10A-AS1 expression on CRC proliferation and metastasis was examined in vitro and in vivo.Mechanistically,we investigated how TNFRSF10A-AS1 is involved in CRC as a competitive endogenous RNA.RESULTS TNFRSF10A-AS1 was expressed at a high level in CRC and the upregulation of TNFRSF10A-AS1 was associated with advanced T grade and tumor size in CRC patients.A functional investigation revealed that TNFRSF10A-AS1 enhanced the proliferation,migration ability and invasion ability of colon cancer cells in vitro and in vivo.A mechanistic analysis demonstrated that TNFRSF10A-AS1 acted as a miR-3121-3p molecular sponge to regulate HuR expression,ultimately promoting colorectal tumorigenesis and progression.CONCLUSION TNFRSF10A-AS1 exerts a tumor-promoting function through the miR-3121-3p/HuR axis in CRC,indicating that it may be a novel target for CRC therapy. 展开更多
关键词 Colorectal cancer Long noncoding RNA TNFRSF10A-AS1 miR-3121-3p HUR
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Bioinformatics-based analysis of the relationship between core genes and immune infiltration and tumor metastasis in esophageal cancer
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作者 Fa-zhang Chen Ye Li +2 位作者 Xue-lian zhang xiao-lan zhang Ru-yi Yang 《Gastroenterology & Hepatology Research》 2022年第1期32-45,共14页
We analysed four gene microarray datasets by GEO2R and obtained differential genes expressed in oesophageal cancer.To further elaborate the functions of DGEs,this study performed gene ontology(GO)and Kyoto Encyclopedi... We analysed four gene microarray datasets by GEO2R and obtained differential genes expressed in oesophageal cancer.To further elaborate the functions of DGEs,this study performed gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis of DEGs.We constructed protein interaction networks of DGEs through the String database and screened core genes.We used the GEPIA online database with the Kaplan-Meier plotter database to verify the expression of Hub genes in expressed normal versus tumour tissues and the effect of Hub genes on overall and disease-free survival in oesophageal cancer.To further understand the relationship between Hub gene and tumour metastasis,we analysed the difference in Hub gene expression in patients without metastatic oesophageal cancer versus those with metastatic oesophageal cancer with the help of the HCMDB database.The relationship between Hub genes and tumour immune infiltration was analysed by the TIMER database.We obtained a total of 149 DEGs,of which 49 were up-regulated genes and 100 were down-regulated genes.These DGEs were importantly enriched in IL-17 signalling pathway,ECM-receptor interactions,p53 signalling pathway,estrogen signalling pathway,complement and coagulation cascade response.We screened 10 Hub genes,MMP9,CXCL8,COL1A1,TIMP1,POSTN,MMP3,MMP1,COL3A1,SERPINE1,LUM,among 149 DGEs.hub genes were all up-regulated in expression in esophageal cancer tissues,in addition,MMP9,T1MP1,CXCL8,POSTN and The expression of COL3A1,LUM,MMP1,MMP3,MMP9,POSTN,SERPINE1 and TIMP1 was positively correlated with the infiltration of immune cells in the tumor microenvironment.In conclusion,our study identified 10 signature genes for oesophageal cancer.These genes are associated with the development,metastasis,prognosis and immune infiltration of oesophageal cancer and may be markers of development,metastasis and prognosis as well as targets for immunotherapy. 展开更多
关键词 BIOINFORMATICS esophageal cancer data mining GEO immune infiltration.
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采用染色内镜加靶向活检对溃疡性结肠炎进行瘤变长期随访优于白光内镜:一项多中心随机对照试验
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作者 Jian Wan Qin zhang +11 位作者 Shu-Hui Liang Jie Zhong Jing-Nan Li Zhi-Hua Ran Fa-Chao Zhi Xiao-Di Wang xiao-lan zhang Zhong-HuiWen Jian-Qiu Sheng Hua-Xiu Shi Qiao Mei Kai-ChunWu 《Gastroenterology Report》 SCIE EI 2021年第1期14-21,I0001,共9页
背景:单中心或小样本研究数据显示,染色内镜用于溃疡性结肠炎(UC)患者的瘤变监测可能优于白光内镜。我们进行了一项前瞻性随机试验,通过对UC患者的长期随访,比较白光内镜加靶向活检(WLT)、白光内镜加随机活检(WLR)与染色内镜加靶向活检(... 背景:单中心或小样本研究数据显示,染色内镜用于溃疡性结肠炎(UC)患者的瘤变监测可能优于白光内镜。我们进行了一项前瞻性随机试验,通过对UC患者的长期随访,比较白光内镜加靶向活检(WLT)、白光内镜加随机活检(WLR)与染色内镜加靶向活检(CET)的肿瘤检出率。方法:前瞻性纳入2012年3月至2013年12月间11个医学中心收治的UC患者,随机分为WLT、WLR、CET三组。三组患者均仅行高清内镜检查,每年内镜随访一次,直至2017年12月。结果:中位随访55个月,122例入组患者完成了447次内镜检查,纳入最终的完成方案分析,其中WLT组43例,WLR组40例,CET组39例。在21例患者的29次肠镜检查中,共发现34个瘤变。WLR组和CET组诊断瘤变的肠镜检查比例高于WLT组(8.1%和9.7%vs 1.9%;P=0.014,P=0.004)。WLR组活检样本数量显著多于WLT组和CET组(16.4±5.1 vs 4.4±1.4和4.3±3.5;均P<0.001)。在后半程随访中(37-69个月),CET组诊断瘤变的肠镜比例显著高于WLT组(13.3%vs 1.6%,P=0.015),较WLR组则显示出了增高的趋势(13.3%vs 4.9%,P=0.107)。结论:对于UC患者的癌变/瘤变长期监测,CET比WLT更加高效,比WLR更加简单,尤其适用于3年以上的长期随访。本研究于www.chictr.org.cn进行注册(ChiCTR1900023689)。 展开更多
关键词 ulcerative colitis DYSPLASIA CHROMOENDOSCOPY white-light endoscopy
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